Individual
RICHARD SETH THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7730
(318) 629-1732
(318) 629-2735
Mailing address
10450 ELLERBE RD, SHREVEPORT, LA 71106-7730
(318) 629-1732
(318) 629-2735
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/14/2022
Last updated
03/14/2022
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